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Prevalence of Sleep Disordered Breathing in Obese Hypoxemic Individuals, and Association of Adherence to Positive Airway Pressure Treatment with Long Term Oxygen Use and Rates of Health Care Utilization in a Single Centre in Alberta Canada

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Abstract

Obesity affects 25-30% of Canadians. Obese individuals are at increased risk of obstructive sleep apnea (OSA) and the obesity hypoventilation syndrome (OHS), which may cause or complicate chronic hypoxemia. This thesis reports the prevalence of OSA and OHS in a cohort with obesity and chronic hypoxemia referred for sleep testing. Obstructive sleep apnea and OHS were highly prevalent, affecting 80% and 51% respectively. The obesity hypoventilation syndrome was more common than chronic obstructive pulmonary disease in this cohort. Adherence to treatment of OSA and OHS with positive airway pressure therapy was associated with an increase in mean arterial oxygen levels as well as a reduction in the number of individuals requiring oxygen. Adherence with PAP therapy was also associated with a reduction in the rate of hospitalizations though the frequency of outpatient visits rose. These findings support current provincial policies for testing for OSA and OHS in obese hypoxemic individuals.